This study is to define and evaluate home care for the terminally ill within three community-based models--the public home health agency, the private home health agency and the hospital-based home health agency. These in turn will be compared with hospital costs for terminal care within the same geographic area. The results of this study which could be generalized to other areas of rural America will be based on data collected from patients/families/care givers in six Kentucky hospice programs. These will also be compared to a population of terminally ill hospital patients matched to hospice participants by demographic, medical and management data. The three broad areas of analysis will be: 1) quality of patient/family care; 2) professional staff education and support, and; 3) program cost effectiveness.